Analysis of 6381 hepatocellular carcinoma patients in southern Taiwan: prognostic features, treatment outcome, and survival
- 29 February 2008
- journal article
- Published by Springer Science and Business Media LLC in The Esophagus
- Vol. 43 (2), 159-170
- https://doi.org/10.1007/s00535-007-2134-9
Abstract
This hospital-based analysis was conducted to identify prognostic factors of hepatocellular carcinoma (HCC) in a hepatitis B virus endemic area. A total of 6381 HCC cases, diagnosed from 1986 to 2002, were enrolled, and 2890 (42.3%) of them were not treated. Survival rates were analyzed by correlation with the national mortality databank. Missing data and correlations among prognostic factors were considered in the analysis. The overall 1-year, 3-year, 5-year, and 7-year survival rates were 44.3%, 24.9%, 17.1%, and 13%, respectively. Multivariate analysis revealed that the independent factors influencing survival were the initial treatment modality, degree of liver function impairment, hepatitis B surface antigen positivity, tumor status, and α-fetoprotein. Besides these well-known prognostic factors, high alanine aminotransferase (ALT) levels and a high aspartate aminotransferase (AST)/ALT ratio were identified as independent poor prognostic factors. This study, which considered untreated cases, missing data, and correlations between variables and official survival data sets, provides a large-scale comprehensive survival analysis. According to our results, high ALT and high AST/ALT were independent poor prognostic factors. Therefore, viral activity should be controlled in HCC patients, and patients with elevated AST/ALT ratios should be carefully monitored.Keywords
This publication has 40 references indexed in Scilit:
- Updated treatment approach to hepatocellular carcinomaThe Esophagus, 2005
- Prognostic staging system for hepatocellular carcinoma (CLIP score): its value and limitations, and a proposal for a new staging system, the Japan Integrated Staging Score (JIS score)The Esophagus, 2003
- Clinical Management of Hepatocellular Carcinoma. Conclusions of the Barcelona-2000 EASL ConferenceJournal of Hepatology, 2001
- Interferon and prevention of hepatocellular carcinoma in viral cirrhosis: an evidence-based approachJournal of Hepatology, 2001
- A new prognostic classification for predicting survival in patients with hepatocellular carcinomaJournal of Hepatology, 1999
- Effectiveness of interferon alfa on incidence of hepatocellular carcinoma and decompensation in cirrhosis type CJournal of Hepatology, 1997
- Prognostic factors of hepatocellular carcinoma in the west: A multivariate analysis in 206 patientsHepatology, 1990
- Tumor invasiveness and prognosis in resected hepatocellular carcinoma.Clinical and pathogenetic implicationsCancer, 1988
- Prognostic factors in patients with hepatocellular carcinoma attempts for the selection of patients with prolonged survivalCancer, 1987
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958